阿尔茨海默病的前瞻性记忆损害

Prospective memory disorder in patients with Alzheimer＇ s disease

目的 探讨阿尔茨海默病（Alzheimer＇s disease,AD）患者前瞻性记忆（prospective memory，PM）改变的特征，初步了解基于事件的前瞻性记忆（EBPM）和基于时间的前瞻性记忆（ TBPM）在早期AD患者中的损害情况。方法 建立前瞻性记忆的神经心理学测验方法，测试20例AD患者（AD组）以及年龄、教育程度相匹配的20例遗忘型轻度认知损害（amnesia mild cognitive impairment，aMCI）患者（aMCI组）及30名健康人（NC组）。结果 与NC组及aMCI组前瞻性记忆（2.23 ＋0.77、4.83＋1.09，1.00＋1.03、3.10±1.52）及情景记忆成绩（0.70±0.12、0.66 ＋0.16，0.45±0.07、0.54±0.10）相比，AD组的成绩（0.20±0.41、2.05±1.43,0.33±0.12、0.32±0.10）差异均有统计学意义，而EBPM的成绩差异更明显（t=-2.792,P＜0.01；t=-10.761，P＜0.01）。结论 早期AD患者的记忆障碍不仅表现为情景记忆的损害，前瞻性记忆损害可能更为突出，且AD的前瞻性记忆损害与aMCI患者呈现了一致性，提示前瞻性记忆的早期测查可能会有利于AD的早期诊断。

Objective To investigate the event-based prospective memory （EBPM） and time-based prospective memory （TBPM） in patients with Alzheimer＇ s disease （AD）. Methods Twenty patients with AD, 20 adults with amnesia mild cognitive impairment （aMCI） and 30 healthy adults with matched age and education level were assessed with a battery of neuropsychological tests including EBPM and TBPM tasks.Results Compared with healthy elders and patients with aMCI on performance of PM （2. 23 ＋ 0. 77,4.83 ±1.09;1.00±1.03,3. 10 ± 1.52） and episodic memory（0. 70 ±0. 12,0.66 ＋0. 16;0.45 ±0.07,0.54±0. 10）, AD patients were all impaired in PM and episodic memory（0.20 ＋0.41,2.05 ± 1.43;0.33±0. 12,0.32±0. 10）, and were impaired in EBPM more significantly （t=-2.792, P〈0.01;t =-10. 761 ,P 〈0. 01 ）. Conclusions These results suggest that AD patients show deficits of PM, but their EBPM is impaired more significantly. EBPM impairment may be an early diagnostic of AD.